T3 only, high RBC, haemoglobin and hematocrit

[buggles84]

So I'm on 62 mcg of T3 only ,and recently my blood tests showed the above readings indicative of hyperthyroidism.

My TSH measured 0.01, and T3 7.9.

But I'm still gaining weight.

Any ideas people?

My vit d, b12, folate and iron are all in perfect range.

[Hillwoman]

It's difficult to comment on your results without the lab reference ranges for context. Could you provide these? Is the T3 result an Free T3 or Total T3?

I don't know too much about elevated results with regard to blood count.

I put a post up recently with a link to Paul Robinson's blog. He has written extensively about T3 monotherapy (you don't mention taking T4) and he also goes into the reasons why relying on circulating FT3 levels in this circumstance, in order to monitor an individual's dosage, is based on a misunderstanding. He provides references in his latest blog post, but he also discusses the same issue in other recent posts.

[Hillwoman in reply to Hillwoman]

Forgot the link!

recoveringwitht3.com/blog

[Hillwoman in reply to Hillwoman]

And here's another link on the subject of T3-only and blood tests.

recoveringwitht3.com/blog/w...

[buggles84 in reply to Hillwoman]

Yeah, I'm very well educated with regards to paul Robinson's methods.

But without T4, thyroid hormones are certainly not regulated throughout the body.

Physiologically, some organs and tissues will have optimal regulation, whilst some exhibit hyper, and some hypo all simultaneously, which I believe is my issue.

[Hillwoman in reply to buggles84]

If you're well educated with regard to PR's protocol (in turn based on Dr John Lowe's methods) then you will know that any over-replacement with thyroid hormone will not result in hyperthyroidism.

Perhaps it would have been helpful to have stated your views about T4 in your post. Do you have a conversion problem, or suspected peripheral resistance, which has led you to T3 monotherapy?

[buggles84 in reply to Hillwoman]

Yes I have resistance and conversion issues.

But of course over replacement will result in hyperthyroidism!?

Strange statement.

[Hillwoman in reply to buggles84]

Conversion problems and resistance require T3.

Over-replacement is absolutely not synonymous with hyperthyroidism, which is an endogenous condition. Nothing strange about it.

[buggles84 in reply to Hillwoman]

All depends on what your definition of over replacement is.

I mean, if you started taking 200mcg of T3 only per day, I'm pretty sure you'd end up in A&E quickly lol

[SilverAvocado in reply to buggles84]

I think Hillwoman is making a distinction between being over replaced and being hyperthyroid.

In your example of a high dose of T3, the person might be overmedicated, but they wouldn't have developed hyperthyroidism. If they reduced the dose they wouldn't be overmedicated any longer.

However, some people do need such high doses of T3 to feel well. Dr Lowe took a dose of around 200mcg if I recall correctly.

[SilverAvocado]

Hi buggles84,

I've also had a high RBC, Haemoglobin and Haematacrit for several years. It started shortly after my thyroidectomy.

I've been refered to Haematology a couple of times over the years, and they've always said it's not high enough to impress them. I may also be starting to get some other strange iron results, but not sure if they're linked.

Here are some results I've posted on the forum before, I was told that mine weren't bad enough to be of interest, but if they were a few points worse they would be treated:

HB: 156 g/L (118 - 148)

RBC: 5.56 x 10^12/L (3.88 - 4.99)

Haematocrit: 0.452 L/L (0.390 - 0.440)

I've posted the rest of this full blood count and a summary of other results in a thread, but never got any knowledgeable comments on this: healthunlocked.com/thyroidu...

In general, symptoms are more important than blood tests. If you're already certain you have thyroid hormone resistance and you're 100% certain that you feel better on this dose than you have on all the lower doses you could continue to raise.

At this point you've got quite a few other options: -Introduce some T4 or NDT, swapping out a complimentary amount of your T3, so the overall dose stays roughly the same.

-Stay on this dose for at least 6 weeks or longer to see if you get further developments, and then reduce slowly, maybe 5mcg every 6 weeks - just to search around for your sweet spot and confirm which you feel best on.

- Stay on this dose and find other things to work on, have you looked into adrenals? Tried excluding gluten and dairy or other more extreme diets such as auto immune paleo? On the forum you can find enormous numbers of other things to investigate.

It's really a judgement call which path you take, there is no obvious right thing to do. It also depends on things you've already tried and the reasons you were on T3 monotherapy in the first place.

You only mention weight gain as a symptom. Unfortunately this is one of the things that doesn't improve for everyone. Some people get to their optimal dose, all other symptoms resolve, but weight is one of those things that can hang around. Same with low temperature.

[Hillwoman in reply to SilverAvocado]

And insulin resistance is often a problem in people with THR too, as I know to my cost. It certainly doesn't help with weight control.

[SilverAvocado in reply to Hillwoman]

Oh dear, I haven't even looked into that side of things. I may be one of the lucky ones, as I am losing weight very slowly at the moment, even though I am still clearly not optimal. I've got a lot to lose, though 😳